Adults who receive hearing aids or other assistive listening devices are often dissatisfied with the limited benefits that they receive. As a result, many hearing aid users seek auditory training to enhance their listening abilities. The goal of this training is to provide long-term benefits that extend beyond the duration of training and that generalize to material and speakers not previously encountered. Unfortunately, there has been little systematic evaluation of how well auditory training leads to improvements in listening performance and whether improvements are maintained over time. Previous studies often suffer from methodological limitations, such as small sample size, absence of control groups, variability in clinician aptitude, limitations in testing protocols, or some combination of these. This project will be the first large-scale study to address the effectiveness of auditory training longitudinally, to compare training methods, and to identify patient variables that predict benefit. For the first specific aim, 70 adult hearing aid users will receive 16 hours of computerized traditional single-talker auditory training during an 8-week period. Their speech recognition performance will be compared to that of a control group of 70 hearing aid users on 4 occasions: pre-training, immediate post- training, 3 months following training, and 6 months following training. Performance will be evaluated with consonant, word, sentence, and perhaps most importantly because of their high face validity, discourse stimuli. The control group will receive qualitatively and quantitatively similar training, albeit in a non-auditory form. For the second specific aim, the effectiveness of a novel method of auditory training will be evaluated. A new group of 70 adult hearing aid users will complete 16 hours of computerized multiple-talker auditory training and complete the same testing schedule as the other participants. Research from memory and second language learning literature leads to the prediction that multiple-talker instruction will be more effective than single-talker instruction in improving listening performance. For the third specific aim, factors that predict long-term, generalizable benefit, such as duration of hearing aid use, will be identified. This project brings together expertise from the fields of audiology, second language acquisition, and cognitive science. It represents a unique opportunity to document the efficacy of auditory training, to improve upon existing auditory training procedures, and to develop predictions about which patients are most likely to receive benefit. PUBLIC HEALTH RELEVANCE Over thirty-one million persons in the United States have hearing loss. Many experience listening difficulties, even after receiving appropriate amplification. The goals of this project are to evaluate whether auditory training can enhance listening performance in persons who have hearing loss and to compare two different training paradigms.